Be an advocate. Be an educator. Start the conversation.
Updated: Feb 15, 2020
I walked into the room of a patient, who was in a facility, at the same moment the floor nurse walked in to give medication. She walked up to him and squirted medication in his mouth. She did not let him know ahead of time, she did not do it with kindness or consideration and she did not stay long enough to even make sure he didn’t choke. I was so disappointed in this care that I found myself filling up with anger.
Just because someone is non-responsive and near death does not take away the fact that they are still human and their experience is real, and difficult. At the very least, she could have said hello to him, let him know she was there and what she was doing. She could have talked to him while she was doing it. She could have dropped a little water on his tongue so the taste was less bitter. She could have stayed a moment to make sure he was okay. And she could have respected him and treated him with kindness but she did not.
So I have a confession; I tracked her down at the nurse’s station and asked if I could talk with her. She immediately pointed to the patient binders and said I would find everything I needed there and started to walk away. I followed her, I asked her to please stop for a minute so we could talk. She said she was busy, and again started to walk away. By now I was just plain angry. So I yelled at her “hopefully you will treat the next person you see kinder than the one you just left” and I turned around and walked away. I could hear her coming up behind me and I won’t lie, I was a little afraid.
But what happened after that was perfect for me and for her. She asked me what I meant and why I said that. I explained that her approach was cold and insensitive, that she didn’t even let him know what she was doing. I explained that he still has feelings and especially because he is unable to verbalize his needs and his eyes are closed, he deserves kindness and consideration. I explained that coming up to someone like that could be scary. I explained that anyone lying in a bed nearing death is probably afraid and it is our job to be their advocate, to be kind and give them the consideration they deserve.
She started to cry. She had just recently graduated nursing school; there were a few hours of discussion about grief in school but nothing about Hospice. (I remember this well). This was the first place that hired her so she took the job because she wanted to be a hospice nurse. She was hoping to be trained, educated and taught how to be a hospice nurse, but instead she was taught how to use the computer program, how to pass meds, where supplies were and whom the team was… but never was she taught anything about bedside care. I got it, I totally got it and I felt so bad for her. So I asked her when her break was and offered to sit with her during her break and help her as much as I could in 30 minutes.
We sat down together and talked Hospice. It was a quick review but it started the conversation and it inspired her to want to learn more. She is not an unkind person; in fact as I started to talk to her, I realized how kind her heart was. This was someone who wanted to do a job she was totally unprepared for. And it reminded me how little education there is for people caring for someone at the end of life; at least in nursing programs. There are wonderful speakers and TED talks, amazing books, podcasts and FB pages, but we need more classes, I would love to teach THAT class.
It’s been about three months since the day I met (yelled at) that nurse. After that day, we would meet once a week for about an hour and there were multiple text conversations in between and I helped her; I guided, encouraged, inspired and supported her. She has since moved away, but continues doing Hospice elsewhere. Yesterday she called to tell me about a patient she had cared for that passed away with her at his bedside. She let me know that she was fully present for him, that she provided comfort, compassion and kindness and she assured me his landing was soft. I am so proud of her.
What if we all took time to educate those who want to learn? What if we shared our tools with others to help build them up? It doesn’t have to be a nurse; it could be any human whose heart chooses to sit at the bedside of a dying patient. Let’s work together to build our Hospice community; this amazing community that does beautiful work can only get better if bigger. Let’s make our community bigger!!!